踝肱指数与老年2型糖尿病患者大血管病变的相关性及其影响因素

Correlation of ankle brachial index with large vascular lesions and related factors in elderly patients with type 2 diabetes

目的探讨多普勒血流探测仪检测踝肱指数(ABI)与2型糖尿病(T2DM)患者大血管相关并发症的相关性及ABI的影响因素。方法抽选我院2013年3月至2014年3月收治的140例老年T2DM患者,采用多普勒血流探测仪检测ABI,根据ABI高低分为低ABI组(ABI≤0.9,49例),正常ABI组(0.9<ABI≤1.3,44例),高ABI组(ABI>1.3,47例),比较3组大血管并发症发生率及临床资料的差异,采用Logistic回归分析ABI异常的危险因素。结果 3组在年龄、病程、糖化血红蛋白(Hb A1c)、三酰甘油(TG)、总胆固醇(TC)、尿酸(UA)及肌酐(Cr)水平方面比较差异具有统计学意义(P<0.05)。3组脑梗死、冠心病、下肢及颈动脉硬化等大血管并发症的发生率具有统计学差异,且低ABI组患者脑梗死、冠心病、下肢及颈动脉硬化等大血管并发症的发生率均最高(P<0.05)。Logistic回归分析显示年龄、糖尿病病史、脑梗死是ABI的独立危险因素。结论多普勒血流探测是一种简单、无创、经济的检查方法,ABI可作为预测T2DM大血管并发症的简易指标,T2DM患者应加强ABI、血脂、血糖水平的检测,尤其是年龄大、糖尿病病程长以及存在脑梗死的患者。

Objective To explore the correlation of ankle brachial index（ ABI） detected by Doppler blood stream detector with large vascular lesions in the elderly patients with type 2 diabetes mellitus（ T2 DM）. Methods140 elderly patients with T2 DM receiving the detection of ABI using Doppler flow detector from March 2013 to March 2014 were selected,and were divided into low ABI group（ ABI≤0. 9,49 cases） and normal ABI group（ 0.9〈ABI≤1. 3,44 cases）,high ABI group（ ABI 1. 3,47 cases）. The incidence of large vascular lesions and the clinical data among three groups were compared. The risk factors for ABI were analyzed Logistic regression. Results Age,course of the disease,the levels of glycosylated hemoglobin（ Hb A1 c）,triglycerides（ TG）,total cholesterol（ TC）,uric acid（ UA） and creatinine（ Cr） showed significant difference among three groups（ P〈0. 05）. Cerebral infarction,coronary heart disease,lower limbs and carotid atherosclerosis and other vascular complications showed significant difference among three groups,and the incidence rate was highest in low ABI group（ P〈0. 05）. Logistic regression model showed that age,course of diseases,cerebral infarction were risk factors for ABI. Conclusions Doppler blood flow detection for ABI is a simple,noninvasive,economic examination method. ABI can be used as a simple predictor for major vascular complications induced by T2 DM. It is important to strengthen the detection of ABI,blood lipids,blood glucose in the patients with T2 DM,especially in the patients with older age,longer course of diabetes and cerebral infarction.